HomeMy WebLinkAbout1991-004100 - sewer & permit �F��1iiIIT
CITY OF ORONO PERMIT TYPE: '=�E���==n �-�F �►���:_��
1335 Brown Rd. South • P.O !a�:_�, r,i; `''-''��`-'`-''
- Permit Number: �s:,�1_,;•�;;
Crystal Bay, Minnesota 55323 Date Issued:
(612) 473-7357
SITE ADDRESS: �i::.;� ;;;,•f,;:�G�3�� �:��
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A PLICANT'PERMITEE SIGNATURE C/ ISSUED BY SIGNATURE��11/�
CITY OF ORONO APPLICATION FOR UTILITY PERMITS
Box 66_ (1335 So Brown Rd) SEWER WATER
Crystal Bay, MN 55323 ���
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I: You ma�yta ply�or utility permits by mail or in person at the City offices.
2. Mail-ed in applications are subject to the postage and handling fees shown below.
Permit cards will be sent by return mail the sam� day the application is received.
3. Pe�u.ts are mt valid until you reoeive a pe.�ai.t card.
4. Work must not begin unless the permit card is available on the job site.
5. Utility connection permits may be issued to licensed contractors only.
6. Contact the Public Works Departm�nt (473-7357) for utility stub as-built locations.
DO NOT EXCAVATE IN ANY SZREET AND DO NCyr TAP ANY M�N without express approval of the
Public Works Department. Issuance of a permit does not grant this approval.
7. A11 work must be done in accordance with State Code requirements.
8. All work must be inspected before it is covered. Cal 1 473-7357.
24 haur notic�e reqni r�.
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JOB SITE ADDRESS: ��� � I�� u �4E�w �L' -
Occupancy Type: �_Residen ial Commercial
OWNER'S NAI�: (f �G� � �JG�� Phone No. :
Mailing Address : City:
// ,, �. � � y�'� - �/5�`7
CONTRACTOR'S NAML: � f� ' (,� -`fi�'`
�,� f,�,� ry �= ��c��r � Bus. Phone•
Mailing Address: CUS�%1 c.> . ,�� i5- City: Y�<<<n� Zip: ys;��/
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P$RMIT TYPE AND FEE CALCIILATION
MUNICIPAL SEWER CONNECTION ( $30 . 00 per stub) $
pipe size �_inches; material � PVC (on sand fill) ; cast iron
SAC Charge ( $650.00 ) must accompany all sewer permit appl ci ations unless
prepaid. If not prepaid, a sewer connection permit will not be issued.
MIINICIPAL WATER CONNECTION ( $30. 00 per stub) $
pipe size � inches ; material �_ copper; other
WATER METERS must be picked up and paid for at City Ha .
(5/8" meters = $125 . 00 ; 3/4" meters = $163 . 00 ; 1" meters = $218 . 00 )
Water meters must be set and sea led by Orono Water Department (473-7357 )
upon completion of ineter installation.
REQUIRED minimum setbacks from drainfield and septic tanks = 75 '
REQL'IRED setL-dc:k from sewer line = 2G '
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l . Subtotal of above permit requested $
2. State Surcharge . 50
The State Building Code Division Surcharge of .50 per permit must e
included for each well, sewer and water connection permit requested.
3. Postage & Handling (Only mail-in applications ) $ 1. 50
4. TOTAL PERMIT FEE (add lines 1-3 above) $
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The undersigned hereby applies to the City of Orono for issuance of a Utility Permit,
agrees to do all work in strict accordance with the ordinances of the City and the
regulations of the State of Minnesota, an certifies that all statements made on this
application are co�lete, true and oorre�t.
Signature of Applicant: - i Date: ��-� �� c� �
DA T,IME ' i
CITY OF ORONO CALLED IN �� �/��/_��'�'
INSPECTION NOTICE SCHEDULED �S- iS `j� � G" ,C,r�
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PERMIT NO. ��`' COMPI�TED 1f ��
ADDRESS �.� � " ���'
OWNER CONTR.L�% �- 7�'�-��.
TELEPHONE N0. �7 ��� - y GI 5,
� DESCRIPTION
� 01 FOOTING 11 MECHANICAL RI 16 WELLTEST PUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAVIGRADINGIFILLING
y 03 INSULATION 24/25'WOOD BURNER/FIREPLACE 19 LAKESHOREIWETLANDS
Z 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Q 05 FINAL 13 METER SET(TURN ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP 06 PROGRESS
v 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
� 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
J 10 PLUMBING FINAL 23 SEPTIC FINAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:����-`-�'��m-d.�-�n
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d WORKSATISFACTORY:PROCEED ❑ PROJECTCOMP�ETE
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� ❑CORRECT WORK&PROCEED � ISSUE CERTIFICATE OF OCCUPANCY
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O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.47�73�J7
Owner/Contra or qr�site:
Inspector. U
White Copyllnspect r's File Canary CopylSite Notice